HomeMy WebLinkAbout0164 Declaration ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FLORIOA:
This is my d~claration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance a~d
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of _____GT@@Y1W~C~'1 COnn _
~~;ty) (State)
21 A1"11o1d StTeet ~Wever 1 havechan ed m domicjle
and I resided at 9 Y
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since _ 2?I1(~ day of
___~~~smh~z__-_-__, 19~i.4___, and I reside at ~.7~ ~unison Ave. Port St. LuCie
_ ~ J ~l...rL~~1
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of properry or business, or ~elinquishment of employment
at former domicile, removal of family to ~ew domicile, purchase of home, etc.)
~,stablishing residence
~'ILED AND R~COROED
ST, LUC1E COU"~TY, F!
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'70 „~f~'! 5 Ps~1 !2:2s
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~ C! E~tK~ :Ir?~~~j'; ~OURT
I FURTHER CERTIFY that I will comply with al) other requirements of a~legal resident of this State.
1 FURTHER CERTIFY that I have no intention to return to my former domiGle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ • ~ b
' GF. (Name)
~ ~ ' Thomas W. Hillegas
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' ' . _ (Address)
~ Sworn to and subscribed before me this 5th day of January ~ 19 70
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s
ROGER POITRAS ~
~ K CIRCUIT COURT Notary Public ~
~ gy D.C. My Commission expires
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_ F .
(To be executed ie dupliute and originsl ~iled with Clerk Circuit Court, snd duplicste with T~x Assessor.)
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